Single Payer Health Care... Not Yet for the United States

What does Single Payer Health Care look like? How does it work? One need look no further than England, home to the world's largest single-payer health system. Sir David Nicholson, former CEO of England's National Health Service, provided some insight to the single payer health system and how it relates to health care questions posed in our country today.

Money for health care is collected through general taxation in England’s single payer system, which is then given to the department of health, and allocated out to the clinical commission groups. These groups then essentially purchase services from hospitals. The system treats over a million people every 36 hours, according to Sir Nicholson.

But would this work in the United States? Sir Nicholson doesn’t believe so, but offers this advice for the U.S.-- get more help from medical groups themselves, rather than the government.

“I think it’s probably a bridge too far at the moment for the American health care system. It’s not part of your culture. It’s not what you do. But, I do think there’s an important thing, around the way the paying system operates, one of the things that we’ve learned is that we’ve significantly enhanced our ability to organize our payer, by having clinicians involved in the decisions about how you let contracts purchase health care. I think there’s a lot to be said about getting more clinicians involved in your paying system.”

The idea that these medical systems may be classified as socialism has been a debate in the U.S. recently. However, most healthcare systems around the world are a mix of public and private systems, according to Sir Nicholson. Medicare is an example of a government health care plan in the United States which already resembles a mix of public and private.

“The big thing we generally cannot understand, is why people would not want 100% coverage. It seems to me that’s what governments are for, in the sense of governments are for ensuring that people have access to high quality health care. They don’t have to run it, they don’t have to organize it, but they have to make sure it’s there.”

Sir Nicholson said many British people do not understand why anyone would not want to be 100% covered in regards to their health care. The British find the American health care system and the Affordable Care Act to be too complex, says Nicholson, and the system itself will continued to be hotly debated in years to come.

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